NOTES LECTURES RISK BEHAVIOR AND ADDICTION IN ADOLESCENCE
Lecture 1 – 4/9: Introduction Risk Behavior and Addiction in
Adolescence
How do we define Risk Behaviour?
Risk Behaviour
- Risk Behaviour: Behaviours that pose a risk to a healthy physical, cognitive,
psychosocial development of adolescents
Substance use (e.g., smoking/vaping, alcohol use, cannabis use, use of XTC
and other party/designer drugs)
Other risk behaviors (e.g., (online) gambling, gaming, social media use)
- Addiction
The general development process of addiction
Contact with a substance Experimenting with a substance Integrated use (part of
daily life) Excessive use (higher proportions) Addicted use
Something can become a risk behavior when it becomes excessive
Nicotine addiction can develop on very early on, when someone is in a position to start
with smoking
What we tend to regard as ‘risks behavior’ depends on…
- Characteristics of the particular substance or behavior
For instance, smoking/vaping versus gaming
- Cultural and societal norms: what is seen as risk behavior
Example: alcohol use in western versus Islamic cultures
- Advances in scientific knowledge:
Example: knowledge on the risks of alcohol use for the development of the
adolescent brain
Predictors of Risk Behavior
(Risk) behaviors
depend on
three things:
capability,
motivation,
opportunity
The Behavior Change
Wheel
(will be central later on)
Which (neurological) developments take place during adolescence?
Adolescence (+10 – 24 years)
- Early adolescence (aged 10 – 14): physical growth, sexual maturation, psychosocial
development, social identity formation (who am I in the eyes of my peers)
- Mid adolescence (aged 15 – 17): experimenting with (risk) behaviours, personal
identity formation (who am I through my own eyes)
- Late adolescence (aged 18 – 24): practicing adult roles
Neurological development in adolescence
1. Strong grow in brain volume
, NOTES LECTURES RISK BEHAVIOR AND ADDICTION IN ADOLESCENCE
Decrease in grey matter (nerve cells)
Increase in white matter (connections –
brain and cells)
Decrease starts age 11 girls, age 14 boys
Not all parts grey matter is decreasing Pruning (snoeien); depends on which
parts of the grey matters is used, the parts who are less used will disappear –
if you don’t use it, you lose it
2. High plasticity and flexibility of the brain
Phones no sustains attention – through flexibility certain skills can be trained
again and you can gain it again
3. Increase in white matter: communication between brain regions strongly
improves
Long term memory increases
Capacity for abstract (critical) thinking and
metacognition increases
This development certainly results in conflicts
between child and parents
All smaller roads are disappearing, but bigger
stronger roads will appear
Why is there a peak in risk behaviours during adolescence?
Risk behavior follows an inverted U-shaped curve
Neurological development in adolescence
- The speed of the development of two different brain
regions differs
The affective-motivational system
(emotional brain) develops fast
the VTA produces dopamine and
sends it to the nucleus accumbens,
thereby creating feelings of reward
Old part of the brain
Part plays an important role regarding
rewards and motivation
Is overactive during early and mid-
adolescence
Adolescents experience stronger
positive emotions than adults when they receive or anticipate a
reward process is enhanced by testosterone
Boys: generally higher testosterone, they tend to show more risk
behavior
The control system (rational brain) develops slowly
Outside of the brain
, NOTES LECTURES RISK BEHAVIOR AND ADDICTION IN ADOLESCENCE
Develops very slowly (until about 25 years)
Plays important role in the development of executive functions:
Risk estimations
Monitoring long-term goals
Inhibition of the tendency to respond to (short-term) possibilities
for reward (impulse control, behavioral inhibition, self-control)
Systems interact
The Maturational Imbalance Model
- Increased risk-taking during adolescence is
a result of an imbalance between reward
sensitivity (the affective-motivational
system) and impulse control (control
system)
- Risk taking during adolescence is result of
an imbalance
The horse and rider metaphor
- Rider: Control system; keep it in control
– top-down processes, behavioral
inhabitation system (BIS)
- Horse: Motivational system; wants to
run – bottom-up processes, behavioral
activation system (BAS)
What are psycho-active substances
(drugs)?
How can we define drugs or psycho-active substances?
- Psychoactive substances are chemical substances that cross the blood-brain
barrier and affect the function of the central nervous system thereby changing mood,
perceptions, or consciousness (e.g., high/ euphoria, relaxation)
- Other characteristics of psychoactive substances:
They often induce craving after (regular) use
They often evoke loss of control after they have been used (regularly)
Psychoactive substances differ in…
- Type and strength of the psychoactive effect
- The degree to which they elicit craving and loss of control
For which substance is the risk highest to develop addiction after one has used the
substance only once? NICOTINE!
Types of drugs (based on their psychoactive effects)
, NOTES LECTURES RISK BEHAVIOR AND ADDICTION IN ADOLESCENCE
How do we define Addiction?
- Intensional: these definitions aim to describe a causal addiction process (see
Sussman, Table 1.2)
- Extensional: a classification of characteristics of an addiction (e.g. DSM-5, ICD-11)
Substance use disorder (DSM-5 TR, 2022)
- Classification system: you are defined as addicted if you have certain criteria
- Recurrent use over the last 12 months AND meeting at least two or more criteria (2-3
mild, 4-5 moderate, 6> severe SUD)
Which implicit/automatic processes underlie the development of
addiction?
Two learning principles underlying the development of addiction
1. Positive reinforcement occurs when the rate of a behavior increases because a
desirable experience (e.g., euphoria, relaxation) is resulting from the behavior
2. Negative reinforcement occurs when the rate of a behavior increases because an
aversive experience is prevented from happening (e.g., withdrawal symptoms)
The neurobiological of withdrawal symptoms?
VIDEO LECTURE 1 –
https://www.youtube.com/ watch?
v=NxHNxmJv2bQ (EXAM MATERIAL)
Lecture 1 – 4/9: Introduction Risk Behavior and Addiction in
Adolescence
How do we define Risk Behaviour?
Risk Behaviour
- Risk Behaviour: Behaviours that pose a risk to a healthy physical, cognitive,
psychosocial development of adolescents
Substance use (e.g., smoking/vaping, alcohol use, cannabis use, use of XTC
and other party/designer drugs)
Other risk behaviors (e.g., (online) gambling, gaming, social media use)
- Addiction
The general development process of addiction
Contact with a substance Experimenting with a substance Integrated use (part of
daily life) Excessive use (higher proportions) Addicted use
Something can become a risk behavior when it becomes excessive
Nicotine addiction can develop on very early on, when someone is in a position to start
with smoking
What we tend to regard as ‘risks behavior’ depends on…
- Characteristics of the particular substance or behavior
For instance, smoking/vaping versus gaming
- Cultural and societal norms: what is seen as risk behavior
Example: alcohol use in western versus Islamic cultures
- Advances in scientific knowledge:
Example: knowledge on the risks of alcohol use for the development of the
adolescent brain
Predictors of Risk Behavior
(Risk) behaviors
depend on
three things:
capability,
motivation,
opportunity
The Behavior Change
Wheel
(will be central later on)
Which (neurological) developments take place during adolescence?
Adolescence (+10 – 24 years)
- Early adolescence (aged 10 – 14): physical growth, sexual maturation, psychosocial
development, social identity formation (who am I in the eyes of my peers)
- Mid adolescence (aged 15 – 17): experimenting with (risk) behaviours, personal
identity formation (who am I through my own eyes)
- Late adolescence (aged 18 – 24): practicing adult roles
Neurological development in adolescence
1. Strong grow in brain volume
, NOTES LECTURES RISK BEHAVIOR AND ADDICTION IN ADOLESCENCE
Decrease in grey matter (nerve cells)
Increase in white matter (connections –
brain and cells)
Decrease starts age 11 girls, age 14 boys
Not all parts grey matter is decreasing Pruning (snoeien); depends on which
parts of the grey matters is used, the parts who are less used will disappear –
if you don’t use it, you lose it
2. High plasticity and flexibility of the brain
Phones no sustains attention – through flexibility certain skills can be trained
again and you can gain it again
3. Increase in white matter: communication between brain regions strongly
improves
Long term memory increases
Capacity for abstract (critical) thinking and
metacognition increases
This development certainly results in conflicts
between child and parents
All smaller roads are disappearing, but bigger
stronger roads will appear
Why is there a peak in risk behaviours during adolescence?
Risk behavior follows an inverted U-shaped curve
Neurological development in adolescence
- The speed of the development of two different brain
regions differs
The affective-motivational system
(emotional brain) develops fast
the VTA produces dopamine and
sends it to the nucleus accumbens,
thereby creating feelings of reward
Old part of the brain
Part plays an important role regarding
rewards and motivation
Is overactive during early and mid-
adolescence
Adolescents experience stronger
positive emotions than adults when they receive or anticipate a
reward process is enhanced by testosterone
Boys: generally higher testosterone, they tend to show more risk
behavior
The control system (rational brain) develops slowly
Outside of the brain
, NOTES LECTURES RISK BEHAVIOR AND ADDICTION IN ADOLESCENCE
Develops very slowly (until about 25 years)
Plays important role in the development of executive functions:
Risk estimations
Monitoring long-term goals
Inhibition of the tendency to respond to (short-term) possibilities
for reward (impulse control, behavioral inhibition, self-control)
Systems interact
The Maturational Imbalance Model
- Increased risk-taking during adolescence is
a result of an imbalance between reward
sensitivity (the affective-motivational
system) and impulse control (control
system)
- Risk taking during adolescence is result of
an imbalance
The horse and rider metaphor
- Rider: Control system; keep it in control
– top-down processes, behavioral
inhabitation system (BIS)
- Horse: Motivational system; wants to
run – bottom-up processes, behavioral
activation system (BAS)
What are psycho-active substances
(drugs)?
How can we define drugs or psycho-active substances?
- Psychoactive substances are chemical substances that cross the blood-brain
barrier and affect the function of the central nervous system thereby changing mood,
perceptions, or consciousness (e.g., high/ euphoria, relaxation)
- Other characteristics of psychoactive substances:
They often induce craving after (regular) use
They often evoke loss of control after they have been used (regularly)
Psychoactive substances differ in…
- Type and strength of the psychoactive effect
- The degree to which they elicit craving and loss of control
For which substance is the risk highest to develop addiction after one has used the
substance only once? NICOTINE!
Types of drugs (based on their psychoactive effects)
, NOTES LECTURES RISK BEHAVIOR AND ADDICTION IN ADOLESCENCE
How do we define Addiction?
- Intensional: these definitions aim to describe a causal addiction process (see
Sussman, Table 1.2)
- Extensional: a classification of characteristics of an addiction (e.g. DSM-5, ICD-11)
Substance use disorder (DSM-5 TR, 2022)
- Classification system: you are defined as addicted if you have certain criteria
- Recurrent use over the last 12 months AND meeting at least two or more criteria (2-3
mild, 4-5 moderate, 6> severe SUD)
Which implicit/automatic processes underlie the development of
addiction?
Two learning principles underlying the development of addiction
1. Positive reinforcement occurs when the rate of a behavior increases because a
desirable experience (e.g., euphoria, relaxation) is resulting from the behavior
2. Negative reinforcement occurs when the rate of a behavior increases because an
aversive experience is prevented from happening (e.g., withdrawal symptoms)
The neurobiological of withdrawal symptoms?
VIDEO LECTURE 1 –
https://www.youtube.com/ watch?
v=NxHNxmJv2bQ (EXAM MATERIAL)
